Mindfulness - Based Stress Reduction and the Relationship on Inflammation in Autoimmune Hepatitis

With the understanding that autoimmune hepatitis has a relationship with psychological stress, the use of a strategy such as mindfulness stress based reduction (MBSR) may similarly have a substantial impact as seen in other disease conditions. The proposed hypothesis is that undergoing MBSR has potential to benefit patients with autoimmune hepatitis in relation to decreased relapse rate and ultimately improved quality of life.

The focus of this study is surrounding the possibility of psychosocial stress for relapse in AIH. The investigators, however, would like to also understand the role of serological testing at the time of these relapses and during states of psychosocial stress to demonstrate if the association can be found. During active disease activity or relapses of autoimmune hepatitis, there is an expected rise in alanine aminotransferase (ALT) and immunoglobulin G (IgG) levels. Demonstrating the correlation of ALT and IgG with disease status and possible improvement with stress modifications is also key for this proposed study.

Inclusion criteria

• Between ages 18-80 years
• Diagnosis of Autoimmune Hepatitis Type I

Exclusion criteria

Medical

• Hospitalization in the last 30 days
• New immunosuppression agent started <6 weeks prior to study
• Patients with concurrent viral hepatitis and/or alcoholic liver disease
• Patients with decompensated cirrhosis (defined as ascites, encephalopathy, variceal hemorrhage)
• Patients with hepatocellular carcinoma
• Patients post-liver transplantation Psychological
• Any psychotic disorder or current psychiatric symptoms

Attitudinal

• Inability to commit to program schedule and attendance of classes

Physical

• Inability to physically attend classes; disability or physical impairment not included as an exclusion criteria Other
• Inadequate English proficiency
• Inability to read and/or write